| NPI | 1811141849 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD DEMAS Medical Director / Owner 910-667-0471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 153430) |
| Enumeration Date | 2008-11-04 |
| Last Update Date | 2008-11-04 |